Infertility in Men

Definition

Infertility is not being able to conceive after a year of regular, unprotected sex. About one-third of infertility is caused by male factors and one-third are caused by female factors. In the remaining cases, the cause is unknown or is due to problems with both partners.

Men are considered infertile if they:

Produce too few sperm cells

Produce sperm cells of poor quality

Have chronic problems with ejaculation

Causes

Portions of the brain called the pituitary gland and hypothalamus, as well as male reproductive organs such as the testes affect fertility in men. Problems in any of these areas may decrease fertility.

In about half of the cases, a cause cannot be found. Some factors that can contribute to infertility include:

Symptoms

Inability to have a child after one year of trying to conceive.

Diagnosis

During the first visit, you and your partner will both be evaluated. You will be asked about your symptoms, medical history, and work history. Your doctor will look for potential exposure to certain chemicals. Your doctor will also look for physical problems that might cause infertility.

Medication

If you have a hormonal imbalance, your doctor may prescribe medication. Clomiphene citrate, for example, is an anti-estrogen drug. In combination with vitamin E, it may help increase sperm count and improve sperm movement.

Surgery

Surgery is done for conditions like varicocele that can affect fertility. Treatment of a varicocele does not always restore fertility.

Surgery may also be done to reverse
a
vasectomy
. This reversal is not always successful.

Assisted Reproductive Technologies (ART)

ART involves using human sperm and eggs or embryos in a lab to help with conception. The eggs and sperm can be from you and your partner or donated. ART methods include:

Artificial insemination—semen is collected and processed in a lab. It is then inserted directly into the woman's cervix or uterus.

In vitro fertilization (IVF)
—an egg is removed from the woman's body and mixed with sperm in a lab. The egg and sperm mixture or a 2-3 day old embryo is then placed in the uterus.

Gamete or zygote intrafallopian transfer (GIFT or ZIFT)—an egg is removed from the woman's body and mixed with sperm in a lab. The egg and sperm mixture or a 2-3 day old embryo is then placed in the fallopian tube.

Blastocyst intrafallopian transfer—an egg is removed from the woman's body. The egg is injected with sperm and allowed to develop. It is later implanted into the uterus.

Intracytoplasmic sperm injection—a single sperm is injected into the egg. The resulting embryo can be implanted into the uterus or frozen for later use.

Prevention

Infertility cannot always be prevented; however, the following steps may help:

Avoid:

Use of tobacco, marijuana, opiates, and anabolic steroids

Exposure to harmful chemicals and heavy metals

Excessive use of alcohol

Protect yourself from STDs by using
condoms
. Minimize the number of sexual partners you have.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Jorgensen N, Carlsen E, Nermoen I, et al. East-West gradient in semen quality in the Nordic-Baltic area: a study of men from the general population in Denmark, Norway, Estonia and Finland.
Hum Reprod.
2002;17:2199.

Reproductive health and the workplace.
The National Institute for Occupational Safety and Health website. Available at:
http://www.cdc.gov/niosh/topics/repro. Updated June 10, 2014. Accessed October 27, 2014.